Healthcare Provider Details

I. General information

NPI: 1851422380
Provider Name (Legal Business Name): CRAIG GINSBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 BETHLEHEM PIKE
ERDENHEIM PA
19038-8215
US

IV. Provider business mailing address

323 WENNER WAY
FORT WASHINGTON PA
19034-2919
US

V. Phone/Fax

Practice location:
  • Phone: 215-816-6000
  • Fax: 215-836-2728
Mailing address:
  • Phone: 215-816-6000
  • Fax: 215-836-2728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD033994E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: